HomeMy WebLinkAboutLA197389 PERMIT
Clty Of LakeVille Permit Type: Electrical
20195 Holyoke Ave Permit Number: LA197389
Lakeville,MN 55044
(952)985-4440
* L A 1 9 7 3 8 9 *
www.lakevillemn.gov Date Issued: 11/OS/2021
Site Address: 5075 161st St W
Lot: Block: Addition: Spirit of Brandtjen Farm 24th Addition
PID: 22-71348-02-010
Use: SBF 24th Bldg 19 * Z 2 — 7 1 3 4 8 — 0 Z — 0 1 QJ *
Description:
Sub Type: CommerciaUIndustrial
Work Type: New
Description: 9 Unit aparhnent building
Comments:
Fee Summary: Descri t�ion Amount Revenue Code
Valuation: 67,500.00 EL-Commercial-New $725.00 1000-4167
Surcharge-Based on Valuation $33.75 1000-2127
Total: $758.75
Contractor: - Appil�a,,t - Owner:
Burnsville Electric
14340 County Road 5
Burnsville MN 55306
(612)363-0407
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO:(1)THE APPROVED PLANS&
SPECIFICATIONS;(2)THE APPLICABLE CITY ORDINANCES&CODES;AND(3)THE MN STATE BUILDING CODE.
Please provide a minimum of a 24 hour notice to schedule inspections.BUILDING INSPECTIONS:(952)985-4440,8 am-4:30 pm,M-F
ELECTRICAL INSPECTIONS: Call Brian Grey at(507)381-1791,7-8:30 am,M-F to schedule appointments
ry 1��.�
Applicant/Permitee: Signature Issued By: Signature
ffice Use O�
ELECTRICAL PERMIT APPLICATION I
Permit Number�
CITY OF LAKEVILLE
t ! BUILDING INSPECTIONS DEPARTMENT Received By
/ 20195 HOLYOKE AVENUE -y
LAKEVILLE,MN 55044 � I q �p �
952-985-4440 Date Received
www.lakevillemn.t*,ov ����� 7�
Submit to:permits@lakevillemn.qov Fee Total
DATE 11/3/2021 YOUR E-MAIL ADDRESS tl@burnsvilleelectric.com
siTE ann�ss 5075 161 st Street
TEN�,rtT Garrett Companies sUtTE No. Buildina 19
THE APPLIANT IS: ❑RESIDENT OWNER ❑✓CONTRACTOR
NAME Garrett COmqanleS
RESIDENT OWNER �D1�ss 1051 Greenwood Sprinqs BLVD
CI� Greenwood STATE IN ZIP 46143
DAYTIME PHONE#WHERE YOU CAN BE REACHED
COMPANY NAME Burnsville Electric LICENSE#EA 000342
CONTRACTOR ADDREss 14340 Countv Rd 5
Companynamemustbeas CITY BUPt1SVlll2 STA'rE MN ZIP 55306
appears on State License oFFICE PHo1vE# 952 435 9062 FAX# 952 435 7556
coNTacT N�E TJ Jakubic rxorrE 612 282 7392
❑SINGLE FAMILY 0✓MULTI-FAMILY ❑SWIMMING POOL
❑TWO FAMILY ❑COMMERCIAL/INDUSTRIAL ❑UNDEFINED
PERMIT TYPE
❑TOWATHOUSE ❑MANUFACTURED HOME �FIRE ALARM POWER
❑Meter Bank (Contractor Only) �SIGN
❑Single Meter ❑INSTITUTIONAL �OTHER(see descriprion)
Residenrial Addition/Remodel Permits Available on-line
D�W ❑ADDITION �ALTER/REMODEL
TYPE OF WORK
❑MAINTENANCE/REPAIR ❑TENANT FINISH �DEMOLITION
Only Licensed Electrical Contractors can do work in a Townhouse t6at has meter bank instead of single meters attached to the anits.
Only Licensed Electrical Contractors can do work in Manufactured Home Parks.
�FTAII FI� IIFSrRIPTIC�N C�F WnRK•��Jnj��art�,nt R�dl inn
RESIDENTIAL FEES:
New Construction: $135.00+$1.00 State Surchazge (up to three trips)
Repairs: $40.00+$1.00 State Surcharge (one trip)
Additions,Remodel,Lower Level: $70.00+$I.00 State Surcharge (two trips)
C��'IIVIERCI.�I,FEES: Minimum of$40.00+$�,pp State Surcharge(one trip)—Remodel Miuimum S70.00+S1.00 State Surcharge(two trips)
JOB COST: $ 67,500.00 Example:$12,000 Job Cost
1-1/2%of contract cost up to$10,000 $150.00 $10,000.00 x 1.5%_ $150.00
1%of cost above$10,000 plus surcharge + $575.00 $ 2,000.00 x 1% _ + 20.00
(Surcharge=Contract Cost x.0005) + $33.75 $12,000 x.0005 = + 6.00
TOTAL = $758.75 = $��6.00
I hereby apply for an electrical permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Lakeville and with the Minnesota Electrical Act;that I understand this is not a permit
but only an application for a permit and work is not to start without a permit;that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
NAME OF APPLICANT(Please Print TJ Jakubic
SIGNATURE OF APPLICANT:
PLEASE NOTE: SEPARA ARE REQUIRED FOR ANY BUILDING,MECHANICAL Bc PLUMBING WdRK